Clinicopathologic characteristics of mixed epithelial/mesenchymal metaplastic breast carcinoma (carcinosarcoma): a meta-analysis of Chinese patients

Abstract

Breast carcinosarcoma is a rare and aggressive subtype of metaplastic breast cancer. Data focusing on breast carcinosarcoma is limited. The purposes of this study are to describe the clinicopathological features of breast carcinosarcoma and to evaluate post-surgical outcomes. Material and methods: All case reports about breast carcinosarcoma in China were collected from eligible papers published in Chinese core periodicals between 1990 and 2015 with key words of breast carcinosarcoma, breast cancer, carcinosarcoma, or metaplastic carcinoma. The survival rates, clinical behaviour, and pathological characteristics were analysed. Results: The mean age of the cohort of 215 patients was 53 years (range, 25-82 years). The tumour size ranged from 2.5 cm to 18 cm. The incidence of pathologically confirmed lymph node metastases was 30.81%. The epithelial component in a tumour may be composed of invasive ductal carcinoma (84.21%), squamous cell carcinoma (7.89%), lipid-rich carcinoma (6.58%), or adenocarcinoma (1.31%). Mesenchymal components may contain different elements ranging from fibrosarcoma (63.16%) to chondrosarcoma (19.73%), osteosarcoma (9.21%), liposarcoma (3.95%), or leiomyosarcoma (3.95%). The five-year survival of the breast carcinosarcoma in 149 patients is 62.6% (CI: 54.9%~0.703%). Conclusions: Breast carcinosarcoma is a rare subtype of metaplastic breast cancer. It is characterised by large tumour size, higher rates of axillary nodal involvement, higher rates of both local and distant recurrence, and is difficult to diagnose with preoperative core needle biopsies. Adjuvant treatment after surgical operation may improve the five-year OS of patients with breast carcinosarcoma.

Case report and literature review on a large MBC with ulceration

“…[4][5][6] The pathological features of MBC are usually triple negative. [7][8][9] In this case, the breast tumor was large but painless and the pathological features were consistent with those reported in the literature.…”

“…Moreover, MBC has low sensitivity to chemotherapy. Although anthracyclines have been recommended to treat this special cancer in a previous study, [9] there is still no standard systematic treatment for MBC. In this case, there was no change in the breast lump after 3 cycles of epirubicin and cyclophosphamide chemotherapy (epirubicin + cyclophosphamide), which may be partly due to the heterogeneity of the patient’s tumor.…”

Metaplastic carcinoma of the breast: real-world outcome from a tertiary cancer centre in India

“…Also, as lymph node involvement is less likely, most patients underwent surgical options upfront and received less chemotherapy or radiotherapy than other TNBCs. One meta-analysis confirmed that adjuvant treatment after surgical management may improve 5-year OS in patients with MPC [26]. Our study also shows that NAT did not add to the OS benefit in the node-positive subset.…”

Unilateral acquired blepharoptosis due to orbital metastatic disease as an initial presentation of an overlooked breast carcinoma — A case report

“…The five-year survival rate in patients with breast carcinoma is 56.7 % with a median survival time of 71 months [ 10 ]. In the invasive ductal carcinoma subtype with metastasis to the liver, orbit, and bones, as noted in the present study, the chances of survival are low.…”